Delilah

Dr. Anderson,

Thank you very much for the information. I actually visited the AHS website on Sunday so I was aware of most of it, but it never hurts to be reminded.

I’m certain you’re aware that the protocol you included is predicated on a dog showing signs of pulmonary distress. This is mentioned in the first milestone notes, but what about dogs like Delilah who show no symptoms? Lilly was as asymptomatic as a dog could get, and you only cage-rested her for 30 days. I remember that because I was the guy schlepping back and forth on Metro busses every few days to visit his dog and counting the days.

Why was 30 days sufficient for Lilly (circa 2002) but not for Delilah? Priscilla’s description said the “pre-medication” period was to build up the dog’s immune system, and I believe she was referring to mostly the doxycycline. It appears that we started Lilly at day 60 of the protocol without any problem. My concern about Delilah is based on her physiology being the opposite of Lilly’s. Lilly was a furry little tank. To call Delilah underweight is putting it mildly. Of course I realize I have the advantage of having seen her twice (once before the spaying) while you haven’t yet examined her. Once you get to, I think you’ll understand why I’m concerned about giving her any more cage-rest than absolutely necessary. Yes, we can improve her nutrition, but her body isn’t going to do much with better nutrients without some stimulation. I’m not worried the melarsomine will kill her, but she was already weak before being spayed. The melarsomine and 60 days of inactivity might leave her unable to do anything for some time.

Yes, the HHS deal for heartworm treatment seems great until you consider the specifics of my situation. I’ll have to board Delilah somewhere since she can’t stay in my house with Hot Rod. Moreover, who’s going to administer the daily meds? Not my “caregivers,” I guarantee. Gone are the days when caregivers became members of my household. Now they’re just clock-watchers. And, can you imagine what a pet taxi might charge for taking Delilah down to HHS daily? That, with the boarding, might dwarf the estimate you quoted.

Just some thoughts.

Scott

From: Marsha Anderson [mailto:hipchick1@sbcglobal.net]
Sent: Wednesday, July 8, 2015 10:03
To: Scott Royall
Cc: Marsha Anderson
Subject: Delilah

I will try to compose and have the verification letter ready to fax tomorrow when I am at PMCK as they have a fax machine and I only do email. Plus I am swamped with work right now and have been working over 12-hour days this week. I have not done a heartworm treatment in many years so I pulled up the recommendations from the American Heartworm Society’s website. I recommend you go to their site and review the information. This is the protocol we would be following. When you look at the protocol it involves actually 120 days of exercise restriction. Initially she needs to be examined and her heartworm test confirmed with an occult and microfilaria test. I don’t know when she got spayed as I have no medical records but I am assuming recently. I agree with the shelter that we should not even think about starting treatment until she has had a month’s recovery from the spay and is in better shape. I was told that she has not had any Immiticide injections yet, that they usually did a month of "premedication" before they started the Immiticide protocol. I am not sure what they mean by "premedication", as I have never heard that term before associated with heartworm treatment and Ms. Lopez did not know exactly. I am attaching the protocol and example of charges. As you can see the treatment at a private facility is extremely expensive. Ms. Lopez told me they would do initial bloodwork and all three injections for $125.00. That is a bargain. We can’t even buy just the drug for that. As far as the exercise restriction, she would do much better in a quiet home environment than in a kennel with constant activity and loud barking dogs all day. Exercise restriction involves keeping her in the house and letting out to go to the bathroom only, then back in the house. I would think you could pay someone to take her over there for the injections – there is a service called Pet Taxi and of course many petsitters in Houston that do that sort of thing. As I said in an earlier email the off label use of the monthly preventatives is NOT the recommended protocol and is reserved only for those patients who are not candidates for the Immiticide treatment or who begin to have complications during it. My verification letter, as they call it will reflect these recommendations. Again you can read all about this on the Society’s website. Waiting until she is in pulmonary distress as you mentioned to do the treatment is not an option because at that point it is much more dangerous and problematic. -Marsha

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Delilah/Leia

Yeah, your process is the standard “Slow Kill” protocol. Delilah is really malnourished, and it is a question whether or not she could handle Slow Kill. No doubt your vets think she can, but that is an opinion. Other vets may genuinely question that opinion. The fact remains that the dog is going to get treated unless HHS vetoes the adoption. Sure, some people will adopt HW+ and not mind the 60-day isolation of the dog, but are they common? HHS just needs to ask themselves what’s in this dog’s best interest. While I sat at your counter Monday, a young single-parent family was adopting a dog. The mother had no knowledge of heartworms, or interest in prevention. She was willing to put whatever was necessary on the application to get the dog, but I wouldn’t want to bet on It staying HW-. We know why I’m trying to adopt Delilah so what are the odds that she will remain untreated? For the record, zero. The treatment just might not be Slow Kill. In fact, Slow Kill would be our fallback if Delilah started showing signs of pulmonary distress.

If that’s not enough to satisfy the spirit of HHS adoption policy, there’s nothing left for me to say. Delilah and I both lose out.

From: Priscilla Lopez [mailto:plopez@houstonhumane.org]
Sent: Tuesday, July 7, 2015 16:28
To: Scott Royall
Subject: Re: Delilah/Leia

I explained to her our Heart Worm process, and she wanted to go over a few things with you.

Priscilla Lopez

Adoption’s Supervisor

Houston Humane Society

14700 Almeda Rd. 77053

houstonhumane.org

On Tue, Jul 7, 2015 at 4:15 PM, Scott Royall <royall> wrote:

Oh, she’s out mobile today so she won’t have time to type something to me for a while. Was there an issue?

From: Priscilla Lopez [mailto:plopez]
Sent: Tuesday, July 7, 2015 16:08

To: Scott Royall
Subject: Re: Delilah/Leia

She said that she was going to contact you.

Priscilla Lopez

Adoption’s Supervisor

Houston Humane Society

14700 Almeda Rd. 77053

houstonhumane.org

On Tue, Jul 7, 2015 at 4:01 PM, Scott Royall <royall> wrote:

Do you mean has she texted me? No, why?

From: Priscilla Lopez [mailto:

plopez]
Sent: Tuesday, July 7, 2015 15:58
To: Scott Royall
Subject: Re: Delilah/Leia

Has she called you?

Priscilla Lopez

Adoption’s Supervisor

Houston Humane Society

14700 Almeda Rd. 77053

houstonhumane.org

On Tue, Jul 7, 2015 at 3:37 PM, Scott Royall <royall> wrote:

Please let me know when you get the letter.

From: Priscilla Lopez [mailto:

plopez]
Sent: Tuesday, July 7, 2015 13:06
To: Scott Royall
Subject: Re: Delilah/Leia

I have talked to her.

Priscilla Lopez

Adoption’s Supervisor

Houston Humane Society

14700 Almeda Rd. 77053

houstonhumane.org

On Tue, Jul 7, 2015 at 12:51 PM, Scott Royall <royall> wrote:

Priscilla,

FYI, my vet has been trying to reach you.

Scott

Delilah/Leia

Dr. Anderson,

My trainer evaluated the dog in question and confirmed my initial evaluation. This dog has the innate traits needed for my requirements. HHS is now just waiting for your verification letter before releasing the dog to me.

In regards to which HW treatment we’ll use, the dog is definitely asymptomatic at this stage so my inclination is to go with the “off-label” Heartgard regime you mentioned. Of course that’s conditional based on your recommendation after you examine her yourself. I understand any existing adult worms will remain in her pulmonary system for up to three years. The HW preventative will prevent them from receiving any additional worm reinforcements as well as making their lives miserable and short. Naturally, I realize I’ll have to watch for any telltales of pulmonary distress, an indication that we will need to switch to the more traditional protocol. However, the reason why I hope we can avoid the “slow kill” method, besides the cost, is something you’ll see immediately in your examination. This dog is already malnourished (giving rise to the belief that she was abandoned), and I’d prefer restoring her body as much as possible first. If harsher methods do become indicated later, at least we can strengthen her internal resources first. However, I don’t think we need to specify a treatment method to HHS.

I need an appointment with you this month to have both dogs examined. If you work Mondays, 3:00 would be a good time since my trainer would be here to help. Hot Rod needs her Rabies vaccination renewed before it expires early next month, and there was some blood work deferred from last August.

Al,

Hopefully, I can get Delilah/Leia by Friday so I’ll see you next Monday.

Scott

Delilah

Priscilla,

Thank you for the clarification regarding Delilah. My veterinarian further adds that the “pre-medication” period also requires cage-rest, raising the boarding time to 60 days. However, the dog was asymptomatic when I evaluated her. If she is able to remain asymptomatic, that affords my veterinarian freedom to pursue treatment protocols that are less severe but still effective. If Delilah is the most suitable dog, I presume she wouldn’t be released to me until you have my veterinarian’s verification letter. Would email suffice?

Regarding alternative dogs, you list the options in the order that we would follow them. I don’t know how much time my trainer will have tomorrow, but, when I first evaluated Delilah last week, the only other GSD mixes “in stock” were Hardy and Bobbi. Maybe others have since arrived, but those two weren’t even interested in being evaluated.

Oh, if my veterinarian is going to treat the heartworms, what is the $125 really for? Yes, I just had to ask. I mean, I’m not above giving HHS an one-time donation, but let’s call it whatever it really is, ok?

Scott

From: Priscilla [mailto:plopez@houstonhumane.org]
Sent: Friday, July 3, 2015 21:53
To: Scott Royall
Cc: al
Subject: Re: Delilah

Scott,

We look forward to seeing you at 3:00pm on Monday to re-evaluate Delilah. If you choose to adopt her, the adoption fee will be waived. However, the heartworm treatment will be $125.

To clarify, Delilah needs to take pre-medications prior to the actual heartworm treatment. The premeds will help make Delilah’s immune system as strong as possible before the treatment begins. She will need to take the pre-meds for one month prior to receiving any injections. She also cannot begin her pre-meds until 30 days after her spay surgery, which was performed on July 1. In other words, she would begin her pre-medications on August 1 and receive her first injection on September 1.

Alternatively, you are welcome to have your own veterinarian treat Delilah for her heartworms. However, we will need a verification letter from your veterinarian stating that he or she will be administering the treatment.

We are very sorry that your search for a new companion hasn’t been easier. We do our very best to give all dogs a chance at finding a forever home. However, we do understand the stress that treating a heartworm positive dog places on you. One other alternative is to choose another dog to adopt. We do have several German Shepherd mixes to choose from. Or, if you prefer, we can notify you when we get another German Shepherd in. If you choose to adopt another dog, we would test for heartworms when it gets spayed/neutered and let you know the results prior to pick up.

Best wishes,

Priscilla Lopez

Adoption’s Supervisor

On Jul 2, 2015, at 9:54 PM, Scott Royall <royall> wrote:

Priscilla,

The main thing still working in Delilah’s favor is the dearth of suitable dogs in the area. It took me five weeks to find one possibility. Therefore, we’re going to do the following: my trainer and I are going to convene at your facility 3:00 Monday to re-evaluate Delilah. If my trainer concurs with my favorable impression of her capabilities, we will proceed with the adoption. However, I need to make sure you understand some things first so that there’s no miscommunication. I simply live too far west to bring the dog back to HHS for the second and third shot. Each trip is a half-hour each way, and that’s if I have a driver. My transportation situation is better today than yesterday, but there’s no guarantee it will stay that way even for a month.

Since I can’t avail myself of your relatively cheap injections, this adoption will cost me far more than your typical ones. I will have to board Delilah for 30 days to let the heartworms dissolve normally. That’s the only way I have to assure she stays quiet. It’s probably no surprise that my vet runs a part-time mobile service, and I think I can get her to administer the last two injections. It will hopefully help reduce the cost if your veterinarians could at least do the first. Again, I’m sorry but it’s just not possible for me to bring the dog back to HHS for the last two.

Of course, this is all contingent on Delilah re-testing well Monday.

Scott

Delilah

Priscilla,

The main thing still working in Delilah’s favor is the dearth of suitable dogs in the area. It took me five weeks to find one possibility. Therefore, we’re going to do the following: my trainer and I are going to convene at your facility 3:00 Monday to re-evaluate Delilah. If my trainer concurs with my favorable impression of her capabilities, we will proceed with the adoption. However, I need to make sure you understand some things first so that there’s no miscommunication. I simply live too far west to bring the dog back to HHS for the second and third shot. Each trip is a half-hour each way, and that’s if I have a driver. My transportation situation is better today than yesterday, but there’s no guarantee it will stay that way even for a month.

Since I can’t avail myself of your relatively cheap injections, this adoption will cost me far more than your typical ones. I will have to board Delilah for 30 days to let the heartworms dissolve normally. That’s the only way I have to assure she stays quiet. It’s probably no surprise that my vet runs a part-time mobile service, and I think I can get her to administer the last two injections. It will hopefully help reduce the cost if your veterinarians could at least do the first. Again, I’m sorry but it’s just not possible for me to bring the dog back to HHS for the last two.

Of course, this is all contingent on Delilah re-testing well Monday.

Scott

Delilah

Al,

Then Delilah is essentially a dead dog because the type of owner who shops at the shelters isn’t going to have the resources and commitment to seclude her for a month. I sure don’t.

Meanwhile, I’m back at zero.

Scott

From: Al Longoria [mailto:al@longoriahausdogtraining.com]
Sent: Thursday, July 2, 2015 12:50
To: Scott Royall
Cc: Priscilla Lopez
Subject: Re: Delilah

Scott,

They won’t start any of the HW treatment until the dog is already in a home. I did confirm that Delilah has not started the treatment.

Al

Delilah

Simply heartbreaking.

From: Scott Royall [mailto:royall@conchbbs.com]
Sent: Thursday, July 2, 2015 12:36
To: ‘Priscilla Lopez’; ‘Al Longoria’
Subject: RE: Delilah

Al and Priscilla,

Priscilla sent what’s evidently the official HHS description of their heartworm treatment process. The description seems written toward dogs already owned, and the fact that this dog has been in HHS custody for a week may greatly simplify matters. The description only mentions there are three injections, with the first two administered a day apart. Depending on when the third injection is due, HHS might have completed treatment by now. I don’t know, but taking the dog back to HHS in the near future for that third injection could be quite difficult.

The other question is about the strongly advised convalescence period. This dog is going straight into a home with another older but active dog, meaning I have no way of keeping this dog calm for a month.

I just saw Al’s email and I must sadly agree with his recommendation. Simply put: Delilah is not ready for adoption. The need to keep her quiet for a month is the critical issue. I don’t think any adopter can reasonably assure that so my opinion is that shelters should not be offering HW-positive dogs until treatment is completed. In regard to Delilah: Priscilla, it is up to HHS to contact me when this dog is truly “ready.” If I still need a dog in a month, I will take her. While this is absolutely heartbreaking, it’s the best I can offer.

Scott

From: Priscilla Lopez [mailto:plopez]
Sent: Thursday, July 2, 2015 10:07
To: Al Longoria
Cc: Scott Royall
Subject: Re: Delilah

Treatment

All dogs must complete pre-medications prescribed to the dogs by the veterinarians at the Houston Humane Society prior to the heart-worm treatment to help build up the body and fight any infection present.

Thorough blood work is sometime necessary to determine the dog’s health prior to treatment. (If pet is 5 yrs and older)

The Houston Humane Society heart-worm treatment consists of 3 injections. After completing all pre-medications, the dog will receive the 1st injection. The dog Must return next day after the 2nd for the 3rd injection.

Our treatment has a very high success rate due to the use of the split treatment. We treat all dos has high risk to ensure the safety of the animal.

The injections are given in the muscle near the spine on the back. This can make the dog sore. which is usually relived by the anti inflammatory that is sent home.

Owners are strongly advised to keep the animal calm and inside during the treatment. This will help prevent the worms breaking up prematurely and then getting caught in the lungs.

This can ultimately cause extreme respiratory distress and even death.

Priscilla Lopez

Adoption’s Supervisor

Houston Humane Society

14700 Almeda Rd. 77053

houstonhumane.org

On Thu, Jul 2, 2015 at 8:39 AM, Al Longoria <al> wrote:

Scott,

That is a pretty big decision. I am happy to make my recommendation after speaking with Priscilla.

Al